Severe Compulsive Overeating: how to obtain a more accurate history through non-shaming, non-blaming interview...

The ability to obtain accurate histories for a comparative study of compulsive overeating and alcoholism was severely compromised by the high degree of denial, shame and self-blame present in these two overlapping disease entities. Areas of overlap included similar progression of the disease, familial tendencies, and the presence of protein enzymatic markers for alcoholism within the bariatric population. Since both shame-based diseases tend to run in the same families, four techniques were developed to reduce the amount of shame that obese patients experienced when talking about family histories and their own compulsive, obsessive disease as it progresses through five identifiable stages. These techniques include: the use of specific non-shaming words and gestures; normalization of patients' history and experiences; education about similar biological, genetic, progressive, stress-related diseases to solidify the disease concept of obesity; and a loosely structured interview format which proceeds from the general to the specific and the past to the present, in an orderly, non-shaming fashion.